NPIMap

Organization Active NPI

Philadelphia VA Clinic

  • VA Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1659315380
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
PHILADELPHIA VA CLINIC
Practice address
214 North 4TH St.
2ND Floor
Philadelphia, PA 19106
Phone
(215) 923-1163
Fax
(215) 923-4032
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Barbara Mayerick
Title
Director, Business Development
Phone
(202) 254-0339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X Primary

Addresses

Primary practice location

214 North 4TH St.
2ND Floor
Philadelphia, PA 19106

Mailing address

214 North 4TH St.
2ND Floor
Philadelphia, PA 19106
Phone (215) 923-1163

National Provider Directory

National Provider Directory
Tax ID family
Coatesville Vamc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659315380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 NORTH 4TH ST.",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19106",
            "telephone_number": "215-923-1163",
            "fax_number": "215-923-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 NORTH 4TH ST.",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19106",
            "telephone_number": "215-923-1163",
            "fax_number": "215-923-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA VA CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAYERICK",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "DIRECTOR, BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "202-254-0339"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.